Why We Need to Stop Fighting Death

In Western culture, death is often described as something to be fought, beaten, or defeated. How often have you heard about those who “beat the odds” or are “battling on”? We rarely stop to question this language, but the metaphors we use matter.

The way we talk about dying reveals how we understand it — and in our current framing, dying has been recast as a medical failure rather than a natural part of life.

The Medicalisation of Dying
Throughout most of human history, death was recognised as an inevitable stage of life. It was embedded in culture, ritual, and community (Ariès; van Gennep). But over the past century, medicine has come to dominate the end of life.

Sociologist Allan Kellehear reminds us:

“Death has become the province of doctors, and dying is increasingly defined as a medical event, rather than a social or spiritual one”.

This medicalisation has many consequences:

• Focus on intervention: Every stage of decline is treated as a condition to be managed, measured, or delayed.
• Endless treatment options: Technology makes it possible to extend life far beyond what was once imaginable, but this often prolongs dying rather than living.
• Marginalisation of the social and emotional: By treating dying as a medical problem, we risk overlooking the relational, cultural, and spiritual dimensions that give it meaning.

As Ivan Illich warned in his classic work Medical Nemesis:

“A society that lives by medical categories lives by values which constantly expand the domain of medicine, and thereby continuously shrink the domain of personal autonomy” .

The Language of War
One of the most striking features of our cultural shift is the way we describe illness and death using the language of war. As Susan Sontag argued in Illness as Metaphor:

“The controlling metaphors in descriptions of cancer are, in fact, drawn from the language of warfare: cancer cells do not simply multiply; they are ‘invasive’… treatment is a ‘battle’”.

The problem with this framing is that it sets up death as defeat. If survival is victory, then dying becomes failure — and those who die may even feel they have “let others down” by not fighting hard enough.

This language also discourages acceptance. It suggests that to stop treatment is to surrender, and to surrender is shameful. In this way, battle metaphors reinforce the medicalisation of dying, casting it as a problem to be overcome, rather than a reality to be lived.

The Body Knows How to Die
Yet dying is not just a medical event. Our bodies carry the knowledge of how to die, just as they carry the knowledge of how to grow, age, and heal.

End-of-life clinicians, doulas, carers, and families often speak of recognising the body’s natural processes as it begins to let go: changes in breathing, withdrawal from food, altered consciousness. These are not signs of failure but part of the body’s wisdom in its final transition.

As palliative care pioneer Dame Cicely Saunders put it:

“You matter because you are you, and you matter to the last moment of your life. We will do all we can, not only to help you die peacefully, but to live until you die”.

Reclaiming this understanding — that death is not a battle but a process our bodies already know — allows us to approach dying with less fear and more compassion.

Voluntary Assisted Dying and the Medical Frame
The legalisation of voluntary assisted dying (VAD) in parts of Australia and internationally has sparked deep debate. For some, it represents compassion and choice in the face of unbearable suffering. For others, it raises difficult ethical and spiritual questions.

Philosopher Margaret Battin notes:

“When medicine has the power to prolong dying indefinitely, the possibility of choosing the time and manner of death can itself become a form of liberation”.

Recent studies in Australia show that many people who seek VAD do so for reasons beyond physical pain. Autonomy, fear of future suffering, and concerns about dignity or social burden often weigh just as heavily (BMJ Supportive & Palliative Care). These findings underline that VAD is about more than medicine — it is about meaning.

Yet paradoxically, the framework for VAD reinforces medicine’s central role. Eligibility is assessed through strict medical criteria. The process requires doctors, paperwork, and protocols. Even the decision to die must be mediated through medical systems (Okninski).

This highlights the importance of the non-medical roles around the dying person. Families, end-of-life doulas, and carers remind us that dignity and support are not only clinical matters. They offer the relational, emotional, and spiritual care that medicine alone cannot provide. Their presence helps re-balance death as not just a medical event but a profoundly social one.

Reframing Death as Part of Life
If we want to reclaim a healthier relationship with death, we must shift away from war metaphors and medical dominance. That doesn’t mean rejecting medicine — but it does mean resisting the idea that death is a medical failure.

Talking openly about dying, acknowledging the body’s natural wisdom, and creating spaces for ritual and community can help us remember:

• Death is not the enemy.
• Dying is not defeat.
• Life’s end is not a battle to win or lose, but a transition we all share.

Join the Conversation
How do you feel about the way we frame dying in our culture?
Do you think war metaphors and medical dominance help or hinder our ability to face death?
And how do you see the role of family, carers, and doulas in reshaping the experience of dying?
​
I would love to hear your thoughts in the comments below.

References

1. Ariès, P. (1981). The Hour of Our Death. New York: Knopf; van Gennep, A. (1960). The Rites of Passage. Chicago: University of Chicago Press.
2. Battin, M. (1998). The Least Worst Death: Essays in Bioethics on the End of Life. Oxford: Oxford University Press.
3. Illich, I. (1975). Medical Nemesis: The Expropriation of Health. New York: Pantheon.
4. Kellehear, A. (2007). A Social History of Dying. Cambridge: Cambridge University Press.
5. Okninski, M. (2023). Voluntary Assisted Dying in Australia — Key Similarities and Points of Difference Concerning Eligibility Criteria in the Individual State Legislation. Journal of Bioethical Inquiry, 20, 337–351. https://doi.org/10.1007/s11673-023-10228-9
6. Saunders, C. (2005). Watch with Me: Inspiration for a Life in Hospice Care. Sheffield: Mortal Press.
7. Sellars, M., et al. (2025). Does voluntary assisted dying impact quality palliative care? A national cohort study of motivations and consequences of VAD enquiries. BMJ Supportive & Palliative Care. Published online first: 14 September 2025. https://doi.org/10.1136/spcare-2024-004946
8. Sontag, S. (1978). Illness as Metaphor. New York: Farrar, Straus and Giroux.